A les­son in re­cov­er­ing from the un­think­able

The Weekend Australian - Review - - Books - Kevin Ra­bal­ais

Five Days at Me­mo­rial: Life and Death in a Storm-Rav­aged Hospi­tal By Sheri Fink At­lantic, 576pp, $29.99 WITH no run­ning wa­ter or elec­tric­ity and the back-up gen­er­a­tors fail­ing as dead bod­ies filled makeshift morgues, day four at the hospi­tal re­sem­bled the front­lines of a war zone.

New Or­leans in the wake of Hur­ri­cane Ka­t­rina, 33C in the shade, and the dis­as­ter in­side Me­mo­rial shifted from hor­ri­ble to hor­rific. While at­tempt­ing to care for and evac­u­ate more than 200 pa­tients, the hospi­tal’s staff lis­tened to re­ports of prison breaks within the city, hostage sit­u­a­tions and gangs with AK-47s roam­ing the drowned streets.

They heard gun­shots out­side the doors where, fol­low­ing the fail­ure of the federal flood-pro­tec­tion sys­tem, wa­ter rose to in­un­date 80 per cent of the city.

To pro­tect those in­side, Me­mo­rial’s chief ex­ec­u­tive dis­trib­uted firearms to se­cu­rity and main­te­nance mem­bers. They had un­der­gone emer­gency drills be­fore but, as Sheri Fink writes in Five Days at Me­mo­rial — part true­crime story and full-fledged in­quiry into med­i­cal ethics amid in­fra­struc­ture col­lapse — “no guide­lines ex­isted for this sit­u­a­tion”.

“It’s like Night of the Liv­ing Dead,” said the city coun­cil pres­i­dent. Oth­ers sought bi­b­li­cal ref­er­ences (Noah, and Sodom and Go­mor­rah) or reached for analo­gies (“be­ing si­mul­ta­ne­ously on the Ti­tanic and in war”). Later, a chap­lain search­ing for sur­vivors com­pared Me­mo­rial to Dante’s The Divine Com­edy.

Medicine dwin­dled by day two. Doc­tors changed the evac­u­a­tion or­der, leav­ing the sick­est for last.

By day five, af­ter learn­ing that not all of their pa­tients would be res­cued, some of those doc­tors eu­thanised the most crit­i­cal in their care. “It was a des­per­ate sit­u­a­tion,” Fink writes, “and (one doc­tor) saw only two choices: quicken their deaths or aban­don them.”

When mem­bers of a mor­tu­ary team ar­rived a week af­ter the last liv­ing pa­tients and staff mem­bers had left, 45 dead bod­ies lined the chapel, morgues, hall­ways and emer­gency room. Among them in­cluded 23 with el­e­vated lev­els of mor­phine and other drugs in their sys­tems — vic­tims, foren­sic in­ves­ti­ga­tors be­lieved, of homi­cide.

A doc­tor turned jour­nal­ist, Fink re­ceived a 2009 Pulitzer Prize for her cov­er­age of the events now ex­panded in this book. Be­sides of­fer­ing a near play-by-play ac­count of ac­tions in­side the hospi­tal, the first half of the book gives back­grounds of the nu­mer­ous per­son­al­i­ties — doc­tors, nurses, staff, pa­tients and fam­ily mem­bers — in­volved. Fink also pro­vides con­text by re­lay­ing his­to­ries of triage and med­i­cal care, com­plete with its com­plex racial com­pli­ca­tions, in the Amer­i­can south.

The sec­ond half of Five Days at Me­mo­rial fol­lows the lawyers and in­ves­ti­ga­tors who pur­sue al­le­ga­tions that in these chaotic days of the break­down and sheer in­ep­ti­tude of city, state and federal emer­gency ser­vices — as well as the hospi­tal’s Dal­las-based head­quar­ters, more than 800km — two doc­tors and sev­eral nurs­ing staff ended pa­tients’ lives.

Fink pur­sues what un­folded at Me­mo­rial as one story — thank­fully an ex­cep­tion rather than a rule among New Or­leans’s hos­pi­tals dur­ing this time — in a city where thou­sands found them­selves stranded on rooftops and thou­sands more waited in des­ig­nated ar­eas where au­thor­i­ties failed to pro­vide drink­ing wa­ter, food or di­rec­tion.

The list of lo­cal and federal fail­ings that she cat­a­logues, cou­pled with Fink’s pro­fes­sional un­der­stand­ing of the obli­ga­tions and thought­pro­cesses of the doc­tors and nurses, gives Five Days at Me­mo­rial the pace of a true-crime story in the vein of Tru­man Capote’s In Cold Blood. One of many dif­fer­ences, of course, is that those Kansas mur­ders (a fam­ily of four in a pop­u­la­tion of 270) were an anom­aly — whereas for years au­thor­i­ties had fore­warned about the sever­ity that New Or­leans would face when (never if) a ma­jor hur­ri­cane struck the city.

Five Days at Me­mo­rial es­tab­lishes a cast in which there are no good or evil play­ers, only hu­mans forced to act in ex­treme cir­cum­stances. Fink’s lack of bias pre­vents the reader from quick judg­ment. Most of all, her cov­er­age — me­thod­i­cal though at times te­dious — along with her drive to dis­cern what went wrong, leads to the reader’s re­fusal to cen­sure those forced to make un­en­vi­able de­ci­sions. In do­ing so, the book touches a read­er­ship be­yond those in­ter­ested in medicine or the de­struc­tion of New Or­leans dur­ing and in the aftermath of Ka­t­rina.

Nearly 10 years af­ter the storm, New Or­leans — a city much more Caribbean than North Amer­i­can, more a sis­ter to Ha­vana than its south­ern equiv­a­lents of At­lanta or Hous­ton — re­tains its im­age as a mecca of mu­sic and cui­sine en­joyed around the world.

The case of Me­mo­rial, one blight on a per­pet­u­ally blighted but re­silient city, pro­vides a primer in what not to do — and how to re­cover from the un­think­able. Fink’s record re­minds us that we can learn more from our fail­ures in such dras­tic times than from our suc­cesses, and how we can re­main hu­man dur­ing the most in­hu­man catas­tro­phes. Kevin Ra­bal­ais is a writer and critic. A long-time New Or­leans res­i­dent, he now lives in Mel­bourne.

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